Provider Demographics
NPI:1154897098
Name:OUSIA PHARMACY CORP
Entity type:Organization
Organization Name:OUSIA PHARMACY CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCANN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:267-980-7272
Mailing Address - Street 1:4343 GUNN HWY
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33618-8729
Mailing Address - Country:US
Mailing Address - Phone:813-252-4076
Mailing Address - Fax:813-252-4754
Practice Address - Street 1:4343 GUNN HWY
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33618-8729
Practice Address - Country:US
Practice Address - Phone:813-252-4076
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:OUSIA PHARMACY CORP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-10-18
Last Update Date:2020-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy